腹部超声联合阴道超声诊断妇产科急腹症的应用价值研究

Research on the application value of abdominal ultrasonography combined with vaginal ultrasonography in diagnosis of acute abdominal pain in gynecology and obstetrics

目的探讨腹部超声联合阴道超声诊断妇产科急腹症的应用价值。方法回顾性分析本院2017年1月至2019年12月收治的妇科急腹症患者资料,选取同时行腹部超声与阴道超声两项检查的病例,共78例,所有病例的诊断均由实验室检查及手术、病理结果证实。观察其影像学特征,评价腹部超声和阴道超声两项检查方式的诊断准确率、敏感度等。结果腹部超声联合阴道超声在妇科急腹症中卵巢囊肿蒂扭转、急性盆腔炎、异位妊娠、黄体破裂、前置胎盘、不全流产的检出率明显高于两种方式单一检测,差异有统计学意义(P<0.05);腹部超声联合阴道超声检出妇科急腹症的例数与金标准更接近,其次为阴道超声;腹部超声联合阴道超声检出妇科急腹症的准确率、敏感度明显高于两种方式单一检测,差异有统计学意义(P<0.05)。结论对于腹部超声检查未明确妇产科急腹症的患者,应开展阴道超声检查,联合两种检查方式对诊断妇产科急腹症有着重要价值。

Objective To investigate the application value of abdominal ultrasonography combined with vaginal ultrasonography in diagnosis of acute abdominal pain in gynecology and obstetrics.Methods The data of a total of 78 patients with gynecological acute abdominal pain undergoing both abdominal ultrasonography and vaginal ultrasonography admitted in our hospital from January 2017 to December 2019 were selected and analyzed retrospectively.All of the diagnosis of cases were confirmed by laboratory examination,surgical and pathological results.The imaging features were observed,and the diagnostic accuracy and sensitivity of both abdominal ultrasonography and vaginal ultrasonography were evaluated.Results The detection rate of ovarian cyst pedicle torsion,acute pelvic inflammatory disease,ectopic pregnancy,corpus luteum rupture,placenta previa and incomplete abortion in gynecological acute abdominal pain by abdominal ultrasonography combined with vaginal ultrasonography was significantly higher than that by single detection of the two methods,with statistically significant differences(P<0.05).The number of cases of gynecological acute abdomen detected by abdominal ultrasound combined with vaginal ultrasound was closer to the gold standard,followed by vaginal ultrasound.The accuracy and sensitivity of abdominal ultrasonography combined with vaginal ultrasonography in the detection of gynecological acute abdominal pain were significantly higher than both of the two single detection methods,with statistically significant differences(P<0.05).Conclusion For the patients with acute abdominal pain in gynecology and obstetrics who are not identified by abdominal ultrasonography,vaginal ultrasonography should be carried out.The combination of the two detection methods is of great value in the diagnosis of acute abdominal pain in obstetrics and gynecology.